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Prevalence and Characteristics of Gastrointestinal Symptoms in SARS-CoV-2 Infection: Systematic Review and Meta-Analysis
33 Pages Posted: 8 Jun 2020
More...Abstract
Background: Gastrointestinal (GI) manifestations of SARS-CoV-2, designated COVID-19, have been reported, including diarrhoea, nausea, vomiting and abdominal pain. The reported prevalence of GI symptoms with COVID-19 infection have varied widely between studies. Here we performed a systematic review and meta-analysis with the aim of determining the prevalence of GI symptoms associated with COVID-19 and examine correlations between rates of GI symptoms and patient demographics and clinical data.
Methods: A search of six English language databases and two Chinese language databases was conducted and data was independently extracted by two reviewers for each language. Meta-analyses were conducted to determine weighted prevalence of GI symptoms and associations with clinical data from each study.
Findings: Twenty-two studies were analysed representing a cumulative cohort of 2,159 patients. Meta-analysis using pooled percentages estimates revealed prevalence of diarrhoea (9·2% 6·55-11·82), nausea (7.4% 4·24- 10·64), vomiting (4·0% 1·85-6·11) and abdominal pain (3·1% 1·28-4·97) within the cohort, although study heterogeneity was high. Positive correlations were found for both nausea and AST (0.58, 0.36-0.80, p<0.0001) and ALT (0.44, 0.19-0.68, P<0.0001) and vomiting and AST (0.29, 0.16-0.42, p<0.0001) and ALT (0.23, 0.09-0.37, p<0.001) while AST was associated with abdominal pain (0.11, 0.03-0.19, p<0.008), although these associations may be influenced by low power.
Interpretation: Caution should be exercised in interpreting GI symptoms as a characteristic of COVID-19 infection but these data confirm that GI symptoms impact a subgroup of infected patients and for vomiting, nausea and pain this may be associated with transaminitis.
Funding Statement: This work was funded by the National Health and Medical Research Council Centre for Research Excellence in Digestive Health.
Declaration of Interests: The authors report no conflicts of interest.
Keywords: COVID-19, gastrointestinal, diarrhoea, nausea, vomiting
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